Erschienen in:
01.03.2020 | Reports of Original Investigations
Acceptability of cardiac donation after circulatory determination of death: a survey of the Canadian public
verfasst von:
Kimia Honarmand, MD, MSc, Jeanna Parsons Leigh, PhD, Claudio M. Martin, MD, MSc, Robert Sibbald, MSc, Dave Nagpal, MD, MSc, Vince Lau, MD, Fran Priestap, MSc, Sabe De, MD, John Basmaji, MD, Andrew Healey, MD, Sonny Dhanani, MD, Matthew J. Weiss, MD, Sam Shemie, MD, Ian M. Ball, MD, MSc
Erschienen in:
Canadian Journal of Anesthesia/Journal canadien d'anesthésie
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Ausgabe 3/2020
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Abstract
Purpose
Cardiac transplantation is a definitive therapy for end-stage heart failure, but demand exceeds supply. Cardiac donation after circulatory determination of death (cardiac DCDD) can be performed using direct procurement and perfusion (DPP), where cardiac activity is restored after heart recovery, or (NRP), where brain blood supply is surgically interrupted, circulation to the thoraco-abdominal organs is restored within the donor’s body, followed by heart recovery. While cardiac DCDD would increase the number of heart donors, uptake of programs has been slowed in part because of ethical concerns within the medical community. These debates have been largely devoid of discussion regarding public perceptions. We conducted a national survey of public perceptions regarding cardiac DCDD.
Methods
We surveyed 1,001 Canadians about their attitudes towards cardiac DCDD using a rigorously designed and pre-tested survey.
Results
We found that 843 of 1,001 respondents (84.2%; 95% confidence interval [CI], 81.8 to 86.3) accepted the DPP approach, 642 (64.1%; 95% CI, 61.1 to 67.0) would agree to donate their heart using DPP, and 696 (69.5%; 95% CI, 66.6 to 72.3) would consent to the same for a family member. We found that 779 respondents of 1,001 respondents (77.8%; 95% CI, 75.1 to 80.3) accepted the NRP approach, 587 (58.6%; 95% CI, 55.5 to 61.6) would agree to donate their heart using NRP, and 636 (63.5%; 95% CI, 60.5 to 66.4) would consent to the same for a family member. Most respondents supported the implementation of DPP (738 respondents or 73.7%; 95% CI, 70.9 to 76.3) and NRP (655 respondents or 65.4%; 95% CI, 62.4 to 68.3) in Canada.
Conclusion
The results of this national survey of public attitudes towards cardiac DCDD will inform the implementation of cardiac DCDD programs in a manner that is consistent with public values.